title: Profiling B-type natriuretic peptide in a stable heart failure population: a valuable adjunct to care.
abstract: OBJECTIVE
  To examine the prognostic importance of absolute values and change in values of BNP in patients with stable heart failure (HF).
  
  
  METHODS
  Five-hundred and fifty-nine patients attending a disease management programme were categorized into tertiles of BNP (group 1; ≤ 95 pg/ml, group 2; 96-249 pg/ml and group 3; ≥ 250 pg/ml). A change in BNP between two stable visits was recorded. Patients were followed up for 1 year for death and a composite morbidity measure of HF hospitalization, all-cause hospitalization, unscheduled visits for clinical deterioration(UC) of HF using survival analysis.
  
  
  RESULTS
  The risk of the combined morbidity outcome increased with increasing tertiles of BNP (Log rank = 17.8 (2), p < 0.001). Furthermore, a 50 and 25% increase in BNP predicted morbidity in stable HF patients with an initial BNP > 200 pg/ml (p = 0.02) and > 450 pg/ml (p = 0.03), respectively.
  
  
  CONCLUSIONS
  In a stable community HF population, an elevated BNP or an increase in BNP predicts an adverse prognosis thereby potentially identifying a population in need of closer clinical follow-up.
authors.affiliation: Department of Cardiology, Heart Failure Unit, St. Vincent's University Hospital and University College Dublin, Elm Park, Dublin 4, Ireland.
authors.forename: A
authors.initials: A
authors.lastname: Jan
authors.forename: N F
authors.initials: NF
authors.lastname: Murphy
authors.forename: C
authors.initials: C
authors.lastname: O'Loughlin
authors.forename: M
authors.initials: M
authors.lastname: Ledwidge
authors.forename: K
authors.initials: K
authors.lastname: McDonald
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis
chemical_list: D020097:Natriuretic Peptide, Brain